A rare incidence of averting ‘maternal near-miss’ in a case of spontaneous uterine rupture in shock

Uterine rupture is a rare but catastrophic obstetric emergency associated with significant feto-maternal morbidity and mortality. There are various risk factors and wide spectrum of clinical presentations have been identified; previous cesarean delivery being most common risk factor. Spontaneous rupture of unscarred uterus is infrequently encountered, but very dangerous for both mother and fetus as remotely suspected. Usually, spontaneous rupture of primigravida uterus is considered almost immune as it is rare but not unheard of; it may occur before or after onset of labour, at term or preterm and with or without fetal heart rate abnormality. The reported case was such a case of spontaneous unscarred uterine rupture with favourable outcome for both mother and baby

LITERARY AND SCIENTIFIC REVIEW OF LEECH THERAPY IN AYURVEDA AND MODERN SCIENCE

Leech Therapy is claimed to be the supreme therapy because of its high efficiency in the curing blood related disorders. According Ayurvedic classics it is safer and less complicated natural process therefore indicated even for the king, rich, old, fearful, weak, women, and the people of tender nature. Records of the medical usage of leeches date back to the beginning of civilization. Modern hirudotherapy differs from that of ancient one because now we do not use wild leeches but grown in a special bio factories where they are in severe quarantine. Except, now a days the leeches used only once. After using a leech it is destroyed this fact excludes infection of the patients. The absolute safety and obvious advantage of hirudotherapy and checked up by thousands of years of experience of mankind and does not cause any doubt in the secretion of medicinal leeches salivary gland, except hirudin inhibitor of ferment thrombin, there is a whole range of biological active combinations. The benefits of leech therapy were earlier thought to be derived from the amount of blood lost, hence relieving congestion and removing the noxious humors. Recent researches have demonstrated that more than the blood loss, it is the salivary secretions of the leech which contain an amazing cocktail of medicinal substances. This has led to its therapeutic use in numerous medical and surgical conditions like varicosities, various skin diseases like scabies, psoriasis, ringworm etc; phlebitis, to reduce post-operative swelling in plastic and reconstructive surgery and pain relief in various arthritic diseases.

Prevalence and Predictors of Complications of Radiofrequency Catheter Ablation for Atrial Fibrillation

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/86907/1/j.1540-8167.2010.01995.x.pd

Dengue Virus Serotypes 1 and 2 Responsible for Major Dengue Outbreaks in Nepal: Clinical, Laboratory, and Epidemiological Features

Dengue virus (DENV) is expanding toward previously nonendemic areas. DENV has recently been introduced in Nepal with limited information. We report the clinical features and serotype distribution of DENV in Nepal during the 2010 outbreaks. A total of 1,215 clinical dengue cases at two major hospitals of central and western Nepal were investigated. Demographic, clinical, and laboratory parameters were recorded. Serum specimens were tested for DENV by IgM/IgG enzyme-linked immunosorbent assays (ELISAs) and reverse transcription polymerase chain reaction (RT-PCR). We confirmed DENV infection in 403 (33%) patients from 12 districts with an estimated case fatality rate of 1.5%. DENV infection was more common in adults (87%) and urban settings (74%). We detected all four serotypes but DENV-1 and -2 were mainly responsible for major outbreaks (92%). Overall, 60% of all DENV infections were secondary and 17% were severe dengue; both being more frequent among the DENV-2 infections. Rash, bleeding, abdominal pain, hepatomegaly, elevated liver enzymes, and thrombocytopenia were significantly more common in severe dengue compared with nonsevere infections. We also confirmed the expansion of dengue to hill urban areas (DENV-1 and -2), including the capital Kathmandu (altitude, 1,300 m) though > 90% cases were from southern plains. Differential clinical and laboratory features probably help in clinical decisions. Multiple serotypes circulation and elevated secondary infections pose potential risk of severe outbreaks and deaths in the future. Therefore, a country with recent dengue introduction, like Nepal, urgently requires a systematic surveillance and appropriate control measures in place to respond to any disastrous outbreaks

Oral potentially malignant disorders: Risk of progression to malignancy

© 2017 Elsevier Inc. Oral potentially malignant disorders (OPMDs) have a statistically increased risk of progressing to cancer, but the risk varies according to a range of patient- or lesion-related factors. It is difficult to predict the risk of progression in any individual patient, and the clinician must make a judgment based on assessment of each case. The most commonly encountered OPMD is leukoplakia, but others, including lichen planus, oral submucous fibrosis, and erythroplakia, may also be seen. Factors associated with an increased risk of malignant transformation include sex; site and type of lesion; habits, such as smoking and alcohol consumption; and the presence of epithelial dysplasia on histologic examination. In this review, we attempt to identify important risk factors and present a simple algorithm that can be used as a guide for risk assessment at each stage of the clinical evaluation of a patient

Modified Isochronous Coordination Function for Enhancement of VoIP Call Capacity over IEEE 802.11 WLAN

Abstract VoIP over IEEE 802.11 wireless local area network (WLAN) is growing very fast and is providing a cost effective alternative for voice communications. WLANs were initially set up to handle bursty nonreal time type of data traffic. Therefore, the wireless access protocols initially defined are not suitable for voice traffic. Subsequently, updates in the standard have been made to provision for QoS requirements of data, especially the real time traffic of the type voice and video. Despite these updates, however, transmitting voice traffic over WLAN does not utilize the available bandwidth (BW) efficiently, and the number of simultaneous calls supported in practice is significantly lower than what the BW figures would suggest. Several modifications have been proposed to improve the call capacity, and recently isochronous coordination function (ICF) was introduced to mitigate the problem of low call capacity. In this paper, we propose a modified ICF which further improves the performance in terms of the call capacity. The proposed scheme uses multiplexing and multicasting in the downlink to substantially increase the call capacity.</p

Coronary Sinus Lead Placement in Patients With Coronary Sinus Ostial Atresia: An Innovative Approach.

This case series demonstrates 2 innovative approaches to successful coronary sinus lead placement in the setting of coronary sinus ostial atresia. Use of venous phase coronary angiography, a computed tomography scan with venous phase, or a left-sided upper extremity venogram may help reveal a variant anatomy and guide tool selection.

Bank Ownership and the Effects of Financial Liberalization

Do financial sector reforms necessarily result in expansion of credit to the private sector? How does bank ownership affect the availability of credit to the private sector? Empirical evidence is somewhat mixed on these issues. We use the Indian experience with liberalization of the financial sector to inform this debate. Using bank-level data from 1991-2007, we ask whether public and private banks deployed resources freed up by reduced state preemption to increase credit to the private sector. We find that even after liberalization, public banks allocated a larger share of their assets to government securities than did private banks. Crucially, we also find that public banks were more responsive in allocating relatively more resources to finance the fiscal deficit even during periods when state pre-emption (measured in terms of the requirement to hold government securities as a share of assets) formally declined. These findings suggest that in developing countries, where alternative channels of financing may be limited, government ownership of banks, combined with high fiscal deficits, may limit the gains from financial liberalization.Credit;Banks;Credit expansion;Financial sector;government securities, banking, investment in government securities, banking sector, state bank, return on assets, bank credit, reserve requirement, bank ownership, national bank, money market, reserve requirements, liquidity ratio, investments in government securities, banking reforms, share of government securities, private bank, capital requirement, monetary fund, cooperative bank, reserve ratio, bank assets, holdings of government securities, banking assets, resource allocation, bank investments, banking sector assets, bank money, banking regulations, bank rate, central bank, government finance, bank money market, working capital, liability management, bank lending behavior, small bank, bank finance, bank size, banking system, foreign exchange, bank data, bankers, banks ? balance sheets, banking reform, bank nationalization, bank groups, banks ? assets, bank financing, banking statistics, government securities market, savings account, recapitalization, bank lending, foreign exchange market, money supply